Department of Urology, Institute of Clinical Scince, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Scand J Urol. 2020 Aug;54(4):277-280. doi: 10.1080/21681805.2020.1776768. Epub 2020 Jun 16.
To prospectively register self-reported pain levels associated with office cystoscopy with or without bladder tumour biopsy and fulguration. During a 15-month period, patients examined with cystoscopy under local anaesthesia graded their pain level using the Visual Analogue Scale (VAS). All patients were examined in the lithotomy position and lidocaine gel was used in all. A bladder instillation or a submucosal injection of lidocaine was given mainly in patients treated with extirpation of larger tumours. The pain perception was graded by the patients as none (VAS = 0) or mild (VAS = 1-3) in 86% of the 1,314 cystoscopies. Fewer patients (65% out of 258) reported VAS 0-3 when cystoscopy with biopsy and fulguration of bladder tumour was performed. More than 97% of all patients stated that they would prefer treatment under local anaesthesia in the case of a future recurrence. The VAS-scores after diagnostic cystoscopy are in accordance with those previously reported, with the absolute majority reporting no or mild pain. Patients treated with extirpation of bladder tumours reported higher levels of pain but still within acceptable limits. This confirms the potential of treating most patients with small-sized bladder tumour recurrences under local anaesthesia.
前瞻性登记与膀胱肿瘤活检和电灼相关的门诊膀胱镜检查的自报疼痛程度。在 15 个月的时间内，接受局部麻醉下膀胱镜检查的患者使用视觉模拟评分（VAS）来评估他们的疼痛程度。所有患者均采用截石位检查，所有患者均使用利多卡因凝胶。在治疗较大肿瘤的患者中，主要采用膀胱灌注或黏膜下注射利多卡因。患者将疼痛感知分为无（VAS=0）或轻度（VAS=1-3），在 1314 例膀胱镜检查中占 86%。在进行膀胱镜检查、活检和电灼膀胱肿瘤的 258 例患者中，报告 VAS0-3 的患者较少（65%）。超过 97%的患者表示，如果未来再次出现复发，他们更愿意在局部麻醉下进行治疗。诊断性膀胱镜检查后的 VAS 评分与之前报道的一致，绝大多数患者报告无疼痛或轻度疼痛。接受膀胱肿瘤切除术的患者报告的疼痛程度更高，但仍在可接受范围内。这证实了对大多数患有小型膀胱肿瘤复发的患者进行局部麻醉治疗的潜力。
